Expansion of B cell precursors after unrelated cord blood transplantation for an adult patient

Mattei, Daniele; Bassan, Renato; Mordini, Nicola; Rapezzi, Davide; Strola, Giuliana; Peretti, Christian de; Grosso, F.; Ferraris, Anna Maria; Castellino, Claudia; Gallamini, Andrea

doi:10.1038/sj.bmt.1705714

Cited by 6 publications

(8 citation statements)

References 8 publications

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“…Hematogones are non-neoplastic B-lymphocyte precursor-like cells that are frequently found in the marrow of children. They are increased in marrow samples from adult patients with marrow regenerative states, immune cytopenias, acquired immunodeficiency, and marrow transplant, especially after cord blood transplant (7–9). By immunophenotypic analysis, hematogones recapitulate the various known stages of BLP maturation (Table 2).…”

Section: Discussionmentioning

confidence: 99%

“…They commonly are present in young children, sometimes comprising over 20% of the marrow cells in normal infants (5, 6). Increased hematogones occur in adult marrow samples in association with marrow regenerative states, immune cytopenias, acquired immunodeficiency, and marrow transplant, especially after cord blood transplant (7–9). Our investigation into ROR1 on hematogones revealed that ROR1 is on a subfraction of hematogones with a specific immunophenotype corresponding to the maturation stage of normal B lymphocyte precursors associated with positive and negative selection.…”

Section: Introductionmentioning

confidence: 99%

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ROR1 is expressed on hematogones (non-neoplastic human B-lymphocyte precursors) and a minority of precursor-B acute lymphoblastic leukemia

et al. 2011

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ROR1 is a receptor tyrosine kinase expressed during embryogenesis, on chronic lymphocytic leukemia (CLL) and in other malignancies. Hematogones (non-neoplastic B-lymphocyte precursors) express surface ROR1 at an intermediate stage of maturation that lacks CD34 or TdT. The neoplastic counterpart to hematogones is precursor-B acute lymphoblastic leukemia (B-ALL), but less than 10% of B-ALL express surface ROR1, and these ROR1+ B-ALL cases have an unusually high frequency of lacking CD34 and/or having t(1;19), a chromosomal translocation that defines a specific subtype of B-ALL.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

ROR1 is expressed on hematogones (non-neoplastic human B-lymphocyte precursors) and a minority of precursor-B acute lymphoblastic leukemia

et al. 2011

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“…(4, 6-10, 12-21) One situation where increased percentages of hematogones are commonly observed is in the post-umbilical cord blood (UCB) transplant setting (17, 22, 23). UCB has been shown to have high numbers and increased generative capacity of B lymphocyte progenitors (24).…”

Section: Introductionmentioning

confidence: 99%

Impact of Bone Marrow Hematogones on Umbilical Cord Blood Transplantation Outcomes in Patients with Acute Myeloid Leukemia

Honebrink

Dayton

Burke

et al. 2012

Biology of Blood and Marrow Transplantation

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Early after umbilical cord blood transplant (UCBT), patients show marked differences in bone marrow (BM) hematogone percentages. Little is known about whether these differences are clinically relevant. We hypothesized that early recovery of hematogones may be associated with improved transplant outcomes. BM aspirates were assessed from 88 patients with acute myeloid leukemia (AML) by two independent reviewers at Day 21 and 100 after UCBT. Inter-observer variability for BM hematogone percentages at these time points showed correlation coefficients of 0.83 and 0.98, respectively (p=<0.01 for both). A high percentage of hematogones at D21 was associated less acute graft vs. host disease (GVHD) grade 3-4 (p=0.01). At day 100, a high percentage of BM hematogones was associated with improved overall survival (p=0.02) and lower treatment related mortality (p=<0.01). This study shows that BM hematogone percentages may be useful prognostic indicators in AML patients following UCBT and should be routinely reported in BM differential counts.

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“…Abnormal expansion of na€ ıve B lymphocytes has been reported after unrelated cord blood transplantation (UCBT) [1,2]. In some cases, the posttransplantation bone marrow (BM) specimens may contain immature blastic-appearing lymphocytes that might be difficult to distinguish from malignant blasts and raise a concern about possible relapsed acute leukemia [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Significance of Increased Blastic-Appearing Cells in Bone Marrow Following Myeloablative Unrelated Cord Blood Transplantation in Adult Patients

Montesinos

Gascón

Martínez‐Cuadrón

et al. 2012

Biology of Blood and Marrow Transplantation

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An abnormal increase of nonleukemic blastic-appearing lymphocytes in bone marrow (BM) specimens has been reported after unrelated cord blood transplantation (UCBT). This study analyzed the incidence, chronology, biological features, and clinical significance of elevated numbers of these cells in a series of 165 consecutive adult patients demonstrating myeloid engraftment after myeloablative UCBT in a single institution. The patients' BM samples were routinely evaluated by cytomorphology at different time points after UCBT. When ≥5% of blastic-appearing cells were detected by cytomorphology in the BM, samples were also evaluated by multiparametric flow cytometry to characterize these cells. Systematic chimerism analyses of BM samples using PCR amplification of short tandem repeat markers were performed. Forty-three patients (cumulative incidence, 26.1%) demonstrated ≥5% of nonmalignant blastic-appearing cells in BM after a median of 101 days after UCBT (range, 28-377 days). All of these patients had full-donor chimerism and a clinical course without leukemic relapse. Multiparametric flow cytometry analyses performed in 36 of the 43 patients showed a polyclonal expansion of B lymphocytes with a broad spectrum of maturation stages. An increased number of nonmalignant blastic-appearing cells was significantly associated with a high number of lymphocytes infused at the time of UCBT and with low rates of acute and chronic extensive graft-versus-host disease, suggesting a potential immunoregulatory role of these cells. The observation of ≥5% nonmalignant blastic-appearing cells in BM samples after myeloablative UCBT is frequent, and these should be distinguished from malignant blasts.

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Expansion of B cell precursors after unrelated cord blood transplantation for an adult patient

Cited by 6 publications

References 8 publications

ROR1 is expressed on hematogones (non-neoplastic human B-lymphocyte precursors) and a minority of precursor-B acute lymphoblastic leukemia

ROR1 is expressed on hematogones (non-neoplastic human B-lymphocyte precursors) and a minority of precursor-B acute lymphoblastic leukemia

Impact of Bone Marrow Hematogones on Umbilical Cord Blood Transplantation Outcomes in Patients with Acute Myeloid Leukemia

Significance of Increased Blastic-Appearing Cells in Bone Marrow Following Myeloablative Unrelated Cord Blood Transplantation in Adult Patients

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